Keeping it Healthy

“Prevention is better than cure!”

There are many lifestyle changes that can help prevent heart disease. If you have an existing heart condition, lifestyle changes may improve your condition and enhance your quality of life.

If you can achieve the following, you will give your heart the best chance of a healthier future.

• Eat a low fat, high-fibre diet
• Exercise most days of the week
• Maintain a healthy weight
• Quit smoking
• Avoid alcohol excess
• Reduce stress

These lifestyle changes target risk factors for heart disease. The more risk factors you have, the more likely you are to develop heart disease in the future. What are the risk factors for heart disease? Learn more below.

Some risk factors for heart disease cannot be modified, such as age, sex, and genetics.

• Age. Ageing increases the risk of developing coronary artery disease, heart attack, heart failure, and certain arrhythmias.
• Sex. Overall, men have a greater risk of heart disease, although women’s risk does increase following menopause.
• Genetics. Some families may have a tendency towards suffering a particular heart condition. How strong this tendency depends very much on each member’s genetics.

The good news is, there are many risk factors that can be addressed.

Addressing these have been shown to reduce your cardiovascular risk, improve your well-being, and prolong your life.

• Poor diet. Consuming excessive sugar, salt, fat, and cholesterol contributes to the obesity, high blood pressure, diabetes, and heart attacks.
• Alcohol. Alcohol excess causes heart failure and increases your risk of developing atrial fibrillation.
• Being overweight or obese. This increases the risk of diabetes, high blood pressure, heart failure, and certain arrhythmias.
• Smoking. Smoking causes damage their inner lining of your blood vessels. It causes thickening and hardening of the arteries, and this is called atherosclerosis. Atherosclerosis leads to heart attacks and strokes.
• High blood pressure. High blood pressure also causes atherosclerosis, which leads to heart attacks and strokes. It is a risk factor for heart failure and atrial fibrillation.
• High blood cholesterol. High cholesterolalso causes atherosclerosis, which leads to heart attacks and strokes.
• Diabetes. Diabetes increases your risk of atherosclerosis, heart attacks, stroke, and heart failure. It is a risk factor for atrial fibrillation.
• Stress. Excessive stress may contribute to risk of heart attack and also affect factors and behaviours that contribute to heart disease, including high blood pressure and cholesterol levels, smoking, physical inactivity, and overeating.

A healthy diet can help reduce your risk of developing coronary heart disease. In individuals who are overweight, healthy eating can reduce your weight, in turn reducing your risk of diabetes and high blood pressure.A healthy diet can also help lower your cholesterol levels and reduce the risk of some cancers. Even if you already have a heart condition, a healthy diet can benefit your heart.

A Balanced Diet

Everyone should aim for a well balanced diet. Fad diets and crash diets may not provide the balance of nutrients you need. The best way to understand a balanced diet is to think of foods in food groups.

A balanced diet includes:

• Plenty of fruit and vegetables.
• Wholegrain foods.
• Some milk and dairy products.
• Some meat, fish, eggs, beans and other non-dairy sources of protein.
• No more than a small amount of foods and drinks high in fats and/or sugar.

It is important to limit:

• Sodium and salt
• Saturated fat
• Sweets and added sugars
• Red meats – select lean cuts wherever possible

Avoid altogether:

• Trans fat
• Partially hydrogenated oils

Fruit and Vegetables

A well-balanced diet should include at least 5 portions of fruit and vegetables a day. Try to vary the types of fruit and veg you eat. They can be fresh, frozen, dried or tinned. Pure unsweetened fruit juice, pulses and beans count as a portion, but they only make up a maximum of one of your five a day, however much you eat in one day.

A portion is about a handful (80 grams), for example:

• 4 broccoli florets
• 1 pear
• 3 heaped tablespoons of carrots
• 8 strawberries

Fats

To help look after your heart health it is important to be aware of the type of fat you consume. Choose foods containing small amounts of unsaturated fat, instead of saturated fat or trans fat.

• Saturated fat. Too much saturated fat can increase the amount of cholesterol in the blood, which can increase the risk of developing coronary artery disease and heart attack.
• Unsaturated fat. Unsaturated fat is healthier than unsaturated fat. It may be monounsaturated (for example olive oil, rapeseed oil, almonds, unsalted cashews and avocado) or polyunsaturated (including sunflower oil and vegetable oil, walnuts, sunflower seeds and oily fish).
• Trans fats. Another type of fat, known as trans fat, can also raise the amount of cholesterol in the blood. Doughnuts, cookies, crackers, muffins, pies and cakes are examples of foods that may contain trans fat.

Improve your diet by doing the following:

• Replace saturated fats with small amounts of mono and polyunsaturated fats
• Cut down on foods containing trans fats.
• Remember that all fats and oils are high in calories, so even the unsaturated fats should only be used in small amounts.

How do I make a start?

Healthy eating is about making healthy food choices on a daily basis. Instead of eating or drinking something unhealthy, replace it with a healthy option. Read and understand the nutritional information on your food packaging. This will make you more aware of the true nutritional value of the food you consume.

Here are some tips to start you off.

• Eat a variety of fresh, frozen, or canned vegetables and fruits without high-calorie sauces or added salt and sugars. Replace high-calorie foods with fruits and vegetables.
• Choose fiber-rich whole grain products such as wholemeal bread and wholemeal cereals.
• Eat poultry and fish without skin, preparing these without added saturated and trans fat. If you choose to eat red meat, opt for lean cuts prepared in a healthy fashion.
• Eat fish at least twice a week. Fish containing omega-3 fatty acids such as salmon, trout and herring are most beneficial.
• Select fat-free and low-fat dairy products.
• Avoid foods containing partially hydrogenated vegetable oils to reduce trans fat.
• Limit saturated fat and trans fat and replace them with the better fats, monounsaturated and polyunsaturated.
• If you need to lower your blood cholesterol, limit your saturated fat intake to 5 or 6 percent of total calories. For someone eating 2,000 calories a day, that’s about 13 grams of saturated fat.
• Avoid drinks and foods with added sugars.
• Choose foods with less sodium and prepare foods with little or no salt.
• To lower blood pressure, aim to eat no more than 2,400 milligrams of sodium per day, and ideally less than 1,500 mg per day.
• If you drink alcohol, drink in moderation. That means up to one drink per day for women and up to two drinks per day for men. You should also have at least 2 alcohol free days per week.

What are the benefits of being active?

Being active means exercising regularly. There are a great number of benefits.

• Reduced risk of heart disease and stroke.
• Improved well-being and quality of life.
• Reduced stress.
• Increased strength of bones, muscles, tendons and ligaments.
• Lower risk of physical injuries.
• Increased muscle mass, making it easier to burn calories and maintain a healthy weight.

What activities are beneficial?

Exercise refers to physical activity for the purpose of improving fitness.

• Aerobic exercises. These benefit your heart, and includes walking, jogging, swimming or cycling. Aerobic exercise should make you feel breathless, yet you should be able to maintain the exercise for a more than a few minutes.
• Muscle strengthening exercises. These improve your stamina and help guard your body from injury. Stronger muscles also boost your metabolic rate, protecting you from gaining excessive weight.

One of the simplest changes you can make to improve your heart health is to start walking. It’s easy to incorporate walking into your daily routine. Furthermore, it’s enjoyable, free, easy, social and great exercise.

A walking program is flexible and easy to stick with it. If you already walk regularly, consider introducing a more strenuous exercise to your weekly routine such as jogging or swimming.

Strength training is an important part of an exercise program. You may wish to consult with a certified fitness professional who can teach you safe technique and provide a strength-training program tailored to your fitness level.

One set of eight to 12 repetitions, working the muscles to the point of fatigue, is usually sufficient for each muscle group. Aim to exercise each muscle group at least twice per week, ideally with two days of rest between workouts.

How much should I exercise?

For overall cardiovascular health, aim to achieve one of the following goals every week.

• At least 30 min of moderate aerobic exercise at least 5 days a week, OR
• At least 25 min of vigorous aerobic exercise at least 3 days a week, OR
• A combination of the two.

You will also experience benefits even if you divide your time into two or three segments of 10 to 15 minutes per day.

• Moderate to high intensity muscle-strengthening activity at least 2 days a week has additional benefits

For those aiming to lowering their blood pressure or cholesterol, aim for:

• At least 40 min of moderate to vigorous aerobic exercise three to four times a week.

What are the benefits of maintaining a healthy weight?

Maintaining a healthy weight has a great number of health benefits.

If you are overweight or obese, then losing weight will allow you to enjoy these benefits too:

• Reduced risk of diabetes, high cholesterol, and high blood pressure.
• Reduced risk of heart disease and stroke.
• Reduced risk of certain cancers.
• Improved energy levels and sense of vitality.
• Improved sleep quality.
• Fewer joint and muscle pains.

What is my BMI?

Your body is made up of water, fat, protein, carbohydrate and various vitamins and minerals. If you have too much fat, and especially if it is around your waist, then you have and increased risk for such health problems as high blood pressure, high cholesterol, and diabetes. These are all risk factors for heart disease and stroke.

For most people, BMI is a good measure of body fat. BMI stands for body mass index. It is used as a screening tool to identify whether an adult is of a healthy weight. BMI is calculated by dividing your weight in kilograms by your height in metres squared (kg/m²).

If you are under 20 years old, athletic, pregnant, breastfeeding, then BMI may not be the best method of assessing your risk of being overweight or obese.Athletic individuals with dense muscle mass may have a high BMI score but very little body fat. For them, the waist circumference and the skinfold thickness may be more useful measures than BMI.

BMI calculator

Losing weight

“Your food choices are the most important part of losing weight.”

Your weight results from the balance of calories you consume versus the calories you burn each day. What are calories? They are a measure of energy. If you eat more calories than you burn, you will gain weight. If you eat fewer calories than you burn, then you will lose weight.

You can lose weight by reducing unnecessary calories from food and beverages, and increasing calories burned through physical activity. Your food choices, though, are the most important part of losing weight.

Food choices

One pound of excess body weight (half a kilogram) is around 3,500 calories.  If you are overweight, the rule of thumb is that you will need to cut 500 calories per day from your diet to lose about 1 pound (half a kilogram) per week.If you can maintain this, your weight loss will continue for a period then eventually taper off and your weight will stabilize, settling into a lower and healthier weight.

If you can consistently substitute high calorie foods for low calorie foods on a daily basis, you’re well on your way to losing weight. Remember, it’s important to focus on eating healthily rather than “being on a diet”. See our section on healthy eating for tips on a healthy and balanced diet.

You will find there is no shortage of diet plans in magazines, on TV, and online. Some of these have merit, while others are unhealthy and unsustainable. If you are significantly overweight or obese, it may be worthwhile seeing a dietitian or fitness professional to draw up a diet program for you.

There are commercial solutions available such as “Lite n Easy” which delivers healthy prepared meals designed for weight loss. “Lite n Easy” offers an excellent program and is convenient and a good solution for many. For those losing weight on a budget, the free smartphone app “myfitnesspal” is a user-friendly calorie counter and exercise diary that helps you gain insight into the nutritional value and caloric content of the meals you eat on a daily basis.

Where do I start?

If you are overweight or obese, probably the simplest first step in improving your eating habits is maintaining a food diary. Keep an honest record of everything you eat, taking note of the number of calories you consume each day and averaging this over a week. Use the smartphone app “myfitnesspal” to assist you. This contains a huge database of food products and their nutritional information. Once you have an idea of how many calories you consume, aim to reduce your daily intake 500 calories per day and have your GP or dietician monitor you progress.

Please note that our Clinic has no commercial or financial interest in any of the above products and services. These recommendations are made in recognition that weight loss can be challenging but with the right supports can be achieved successfully.

Exercise

Exercise is an important part of any weight loss program. Beyond losing weight, staying active has a great number of benefits which include improved vitality, stress reduction, and prevention of heart disease. You are twice as likely to have a heart attack if you are sedentary than if you participate in regular physical activity.

Nevertheless, when it comes to losing weight, it is worth re-iterating that your food choices are even more important in achieving lasting weight loss. Healthy food choices form the cornerstone of a healthy weight. You are more likely to experience lasting weight loss by spending a few minutes on a food diary every day compared to 30 min of exercise 5 days a week.

So in addition to healthy eating, exercise will help you along. Exercise can be planned or incidental. Planned exercise is where you set aside time to exercise, whereas incidental exercise is physical activity performed while doing something else, such as walking to the local shops.

A basic exercise program begins with 30 min of moderate physical activity at least 5 times a week. Planned cardio exercises such as jogging, cycling, and swimming all help you burn fat while building up muscle at the same time.

If you feel it is too hard to jump straight into any of these activities, then brisk walking for 30 min a day for a few weeks is a great way to start off. Increasing your level of incidental exercise is another useful supplementary strategy. This means walking instead of driving and climbing the stairs instead of using the escalator.

If you have a physical limitation such as arthritis, see a physiotherapist or fitness professional who can help you tailor an exercise program that is right for you.

In addition to cardio exercises, muscle strengthening exercises are of further benefit. Building up the size of your large muscles increases your basal metabolic rate and helps you burn fat even when you are not exercising. It helps increase your endurance and protects you against physical injury.

For those who are serious about exercise, purchasing an activity tracker is a great way to monitor your progress. Simple trackers may simply count the number of steps you take everyday, while more sophisticated ones can track your activity by GPS (for runners and cyclists) and monitor your heart rate.

If you’re a smoker, stopping smoking is the single best thing you can do for your health. Smokers are twice as likely to have a heart attack than non-smokers, and die 10 years younger. You may be well aware of the many other harmful effects of smoking.

The good news is that your health risks associated with smoking decrease significantly soon after you stop, and this includes your risk of heart disease, stroke, and cancer.

“Never quit quitting.”

Quitting smoking is easy for some, but difficult for most. You may have already tried quitting on one or more occasions. In fact, most successful long-term quitters have had several attempts at quitting before finally being successful. Therefore, the advice to you would be to never quit quitting.

What happens when I stop smoking?

There are many health benefits associated with stopping smoking.

After…

• 20 min – Your heart rate and blood pressure begin to normalize.

• 8 to 24 hours – Nicotine and carbon monoxide leaves your body and oxygen levels improve.

• 24 hours – Your lungs begin to clear up mucous and debris from inhaled smoke

• 48 to 72 hours – Nicotine has been eliminated from your body and your sense of smell and taste improve.

• 2 to 12 weeks – Exercise becomes easier and your breathing improves.

• 3 to 9 months – Coughing, wheezing, and breathing problems continue to improve as your lungs repair.

• 1 year – You risk of lung cancer is halved, compared to that of a smoker.

Other benefits include:

• Reduced risk of heart disease and stroke within 1 to 2 years of quitting.
• Lowered risk for lung cancer as well as many other types of cancer, including cancers of the mouth, nose, throat, oesophagus, pancreas, kidney, liver, bladder, bowel, ovary, cervix, bone marrow, and stomach.
• Reduced risk of peripheral vascular disease. Peripheral artery disease impairs blood circulation to the hands and feet, which may result in pain, gangrene, and amputation.

• Reduced risk of developing some chronic obstructive pulmonary disease (COPD) which can cause debilitating breathlessness and recurrent chest infections.
• Reduced risk for infertility in women of childbearing age. If you are pregnant, stopping smoking reduces your risk of having a low birth weight baby.

How do I stop smoking?

The most effective solution is:

Good support + Nicotine replacement (or quitting medications)

Get good support

• Firstly, call the national Quitline on 13 78 48 (8 am to 8 pm, Monday to Friday) and ask for a free Quit Pack to be sent to you. The Australian Government provides excellent support for people interested in quitting.
• Download the mobile phone app My QuitBuddy.
• Visit the quit.org.au to learn more about quitting and resources available to help you succeed.
• Check in with your GP to discuss strategies that are right for you, and importantly to monitor your progress.

Nicotine replacement products

Nicotine replacement products are available from pharmacies and some supermarkets. They are all available without a prescription. Using these products to quit is always safer than continuing to smoke. Note that nicotine by itself has not been found to cause cancer or heart disease.

• Consult your pharmacist to select the right product for you.
• Heavier smokers will need higher dose or to use two nicotine products at the same time (such as a nicotine patch plus nicotine gum or lozenges when required).

Nicotine products will not be as effective if you stop using them too soon.

Prescription medications for quitting

Two quitting medications are available:

• Bupropion (Zyban)
• Varenicline (Champix)

Bupropion alleviates withdrawal symptoms while varenicline makes smoking less satisfying and therefore less addictive. These medications do not suit everyone and may cause strong side effects in a small number of people.

For most people, nicotine patches are the way to go. If you have tried these without success, see your GP about whether medications are suitable for you. You are allowed two courses of bupropion and up to three courses of varenicline every year on the Pharmaceutical Benefits Scheme (PBS). When taking these medications, you will need to have some coaching support, either from from a health professional or from the Quitline.

Drinking excessive alcohol harms your heart and general health. It can cause arrhythmias, high blood pressure, heart failure, and other diseases such as stroke, liver problems, stomach ulcers, and some cancers. Heavy drinkers are at risk of dependency, accidents, depression, and suicide.

Many alcohol beverages are high in calories, and alcohol itself contains 70 calories per standard drink. Regular consumption leads to weight gain. Alcohol also lowers your inhibitions which might mean you find it harder to stick to your healthy eating plans when you have been drinking, and more likely to smoke if you are in the process of quitting.

How much can I drink?

If you drink alcohol, do so in moderation. This no more than 2 standard drinks a day for men and no more than 1 standard drink a day for women. In addition, it is wise to have at least 2 alcohol free days per week. If you are pregnant, you should abstain from alcohol completely.

If you are taking aspirin regularly, drinking alcohol can result in damage to your stomach lining. You may need to limit your alcohol intake further.

Standard drink guide

For those who love red wine

It is said that red wine is good for the heart. Studies looking at alcoholic and nonalcoholic red wine suggest that the protective effect against high blood pressure, heart disease, and stroke is due red wine’s tannins from grape skin.

Tannins contain group of chemical substances found in plants called polyphenols. These are powerful antioxidants known to decrease systolic and diastolic blood pressure by easing blood flow to the heart and organs.

Alcohol in red wine appears to reduce the blood pressure lowering effect of polyphenols, and in excess will lead to other health issues. Therefore, drink in moderation.

Cutting down on your alcohol intake

If you drink more than 14 standard drinks a week and are thinking about cutting back, here are some simple steps that can help you along. 

• Make a plan – Set a limit on how much you’re going to drink, before you start drinking.
• Set a budget – Take a fixed amount of money with you to spend on alcohol.
• Let them know – Let your family and friends know that you’re cutting down and that it’s important to you.They could lend you some valuable support.
• Take it a day at a time – If you can cut back a little each day, you’re well on the road to a healthier life.
• Make it a smaller one – You can still enjoy a drink, but go for smaller sizes. Choose a bottled beer instead of a pint, or a small glass of wine instead of a large one.
• Have a lower-strength drink – Go for a light beer instead of full strength.
• Stay hydrated – Have a glass of water before you drink alcohol, and alternate alcoholic drinks with water or a soft drink.
• Take a break – Have several drink-free days each week.

In some cases, stress can be the direct cause of heart disease. Acute stress can cause heart attacks and arrhythmias for example. However, probably the most important way stress influences your cardiovascular health is by making people more likely to adopt poor lifestyle habits such as unhealthy eating, poor sleep and exercise routines, smoking, and drinking alcohol. These lifestyle factors then serve as risk factors for heart disease in the long run.

Am I stressed?

Stress manifests in many ways. You may recognize stress through thoughts and feelings. Sometimes, physical symptoms may reflect stress. In these situations, it is important to determine if these physical symptoms are truly due to stress, or related to other causes such as an underlying medical condition or medication side effects.

Here are some examples of how stress may affect you.

Aches and Pains

• Headache, backache, and neck aches
• Stomach ache
• Muscle tightness and soreness

Energy Level and Sleep

• Insomnia
• Fatigue
• Oversleeping

Feelings 

• Anxiety and depression
• Anger
• Helplessness
• Feeling out of control

Other Emotional Signs

• Irritability
• Impatience
• Forgetfulness

Thoughts

• Negative or pessimistic thoughts
• Violent thoughts

Dealing with stress

Stress is a normal part of life and affects everyone. However, can become unhealthy if you are unable to deal with your level of stress you are facing as well as you could.

Here are some healthy habits you can adopt to help deal with stress.

• Call on your friends and family. Speaking to your friends and family when things are tough can be a great stress reliever. Some may be great at providing practical advice and others great for emotional support. Forming and maintaining healthy relationships allows you to call on each other when life gets stressful.
• Stay active. Exercise relieves mental and physical tension. Physically active adults have lower rates of depression and anxiety. Exercise increases vitality and can be a great source of enjoyment. Take up walking, cycling, swimming, or dancing. Participate in gym classes or yoga. You may find the social interaction a further source of stress relief.
• Remember to laugh. They say, laughter is the best medicine. Don’t stop yourself from laughing out loud at jokes, comedies, or even ironic situations, even when we’re alone.
• Give up the bad habits. Excessive alcohol, cigarettes, or caffeine increases your blood pressure. Quit smoking and drink alcohol in moderation. Consider cutting out caffeine if is interfering with your sleep pattern.
• Get enough sleep. Aim for 6-8 hours per night. Physical activity also may improve the quality of sleep and life in general.
• Get organized. Make a list each day of what you can realistically achieve and don’t set yourself impossible tasks. Always tackle important things first, these should always come before urgent but unimportant things. When it comes to big tasks, take things one step at a time.
• Slow down. Pace instead of race. It is better to perform your tasks slowly and well rather than quickly and poorly.
• Get in the habit of giving back. Help others out when you can by volunteering or offering up your time. The more support you lend, the more you will tend to receive when you’re in need.
• Have realistic goals. Sometimes, perfect is the enemy of good enough. Many people stress over giving a task their 100% when really 80% is good enough. If that 20% extra isn’t going to make much of a difference to anyone, it’s really not worth stressing over.
• Try not to worry. The world won’t end if your grass isn’t mowed or your kitchen isn’t cleaned. You may need to do these things, but right now might not be the right time.